Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ATHENS ORTHOPEDIC CLINIC, PA
NPI 1104219468
Orthopaedic Surgery in Greensboro, GA

Active since March 11, 2015CLIA 11D2122977 · Waiver
1031 LAKE COUNTRY DR, GREENSBORO, GA 30642(706) 549-1663(706) 546-8792 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 3, 2026, May 8, 2025, Jul 29, 2024 and 3 more (6 updates tracked since 2017).

About Athens Orthopedic Clinic, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ATHENS ORTHOPEDIC CLINIC, PA (NPI 1104219468) is a healthcare organization registered as an orthopaedic surgery in Greensboro, Georgia and active in the NPI registry since March 2015. The organization holds a CLIA Waiver certificate valid through December 11, 2026 and lists Michael Boblitz, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104219468
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameATHENS ORTHOPEDIC CLINIC, PA
Location Address1031 LAKE COUNTRY DRGreensboro, GA 30642-5157
Mailing Address1765 Old West Broad St Bldg 2-200Athens, GA 30606-2887 · (706) 549-1663 · Fax (706) 546-8792
Fax(706) 546-8792
Organization SubpartYes
Authorized OfficialMichael BoblitzCeo · (706) 549-1663
Enumeration DateMarch 11, 2015
Last NPPES UpdateSeptember 3, 20266 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2026
✔ NPI 1104219468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1031 LAKE COUNTRY DR, Greensboro, GA 30642

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2122977

Athens Orthopedic Clinic Ambulatory Surgery Center- Loganville LLC · Loganville, GA
Active · expires Dec 11, 2026
CLIA Number11D2122977
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 12, 2024
Certificate Expiration DateDecember 11, 2026
Laboratory DirectorMichael Shane Smith
Laboratory Phone(706) 549-1663
Laboratory LocationAthens Orthopedic Clinic Ambulatory Surgery Center- Loganville LLC3440 Highway 81, Suite 100, Loganville, GA 30052
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642
Physical Therapist
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642
Orthopaedic Surgery
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642
Physical Therapist
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642
Occupational Therapist
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642
Physician Assistant
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642
Orthopaedic Surgery
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642
Physical Therapy Assistant
1031 LAKE COUNTRY DR
GREENSBORO, GA 30642

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Athens Orthopedic Clinic, PA's NPI number?

The NPI number for Athens Orthopedic Clinic, PA is 1104219468. It was assigned to this organization in the NPPES registry on March 11, 2015.

Where is Athens Orthopedic Clinic, PA located?

Athens Orthopedic Clinic, PA is located at 1031 Lake Country Dr, Greensboro, GA 30642. The listed phone number is (706) 549-1663.

What is Athens Orthopedic Clinic, PA's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Does Athens Orthopedic Clinic, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2122977) is associated with this NPI, valid through December 11, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Athens Orthopedic Clinic, PA was last updated on September 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.